Still Tanning? 6 Sunscreen Mistakes That Are Leaving You Vulnerable to Skin Cancer

I am young, healthy, and goodish about the sun. Oh, wait, you too? Well, let me tell you: None of that mattered the day I found out I had skin cancer. And my scar—a red, mean-looking, five-inch-long number down the back of my left knee to remove a melanoma smaller than a pencil eraser—is a constant reminder that goodish isn’t enough.

Like a lot of women, I thought I was well aware of what I should be doing to protect my skin: using sunscreen, avoiding the sun at its peak, staying in the shade. But knowing doesn’t always translate into doing, or at least doing properly. “Even though the sun-safety message is out there, I can’t tell you how many of my young woman patients aren’t complying with it,” says Elizabeth K. Hale, M.D., a New York City dermatologist and vice chair of the Skin Cancer Foundation. “I have patients who say, ‘If I get skin cancer, you’ll just remove it, and I’ll be OK.’ Others do care but are making mistakes about protecting themselves.” The result: Skin cancer is still on the rise, particularly among women in their twenties and thirties. This year alone, melanoma rates in the U.S. are expected to jump: 76,250 new cases will be diagnosed, and that’s 6,020 more than in 2011. “I’m seeing so many young women with melanoma that it’s scary,” says Dr. Hale. “There’s been an increase among all skin types. Everyone is getting it.” But you don’t have to. Skin cancer is still largely preventable if we can fix some of our mess-ups. They include:

Mistake #1:
Not enough sunscreen!

It’s unanimous—the derms Glamour spoke with agree that most women don’t always use enough SPF to protect themselves. “Not even close,” says Ellen Marmur, M.D., an associate professor of dermatology and vice chair of cosmetic and dermatologic surgery at the Mount Sinai Medical Center in New York City. To get the level of SPF you see on the label, you have to spread the lotion on like a layer of vanilla frosting; that’s the thickness used in Food and Drug Administration tests. But research shows the average person applies just one-quarter to one-half of that amount. “That makes your sunscreen a third less effective, so your SPF 30 is really a 10,” says Steven Q. Wang, M.D., director of dermatologic surgery and dermatology at Memorial Sloan-Kettering Cancer Center in Basking Ridge, New Jersey, and author of Beating Melanoma. “If you then stay out all day—and it happens all the time—you’ve more or less put on sunscreen to protect your conscience, because you’re not protecting your skin.” So don’t skimp: Frost that cupcake! Dr. Marmur also recommends going for a higher SPF—30 to 50—on beach days. You’ll have more of a safety net in case you don’t slather on enough. Speaking of which…

Mistake #2:
Oops, didn’t reapply

You should do it every two hours—hourly if you’re sweating, swimming, or out midday, when the sun’s most intense. “This is another message that hasn’t sunk in with most women,” says Dr. Marmur. According to a study from the Coppertone Solar Research Center, 21 percent of people who use sunscreen never reapply it, even though reapplying has been shown to be one of the most important factors in determining how protective sunscreen is against UV damage and skin cancer. Go two and a half hours without reapplying, and you’re five times more likely to burn. “The ingredients in sunscreen literally break down and become useless after a few hours, even if you’re just sitting in a beach chair, reading a book,” says Dr. Marmur. Reapply! Set a reminder alarm on your phone if you need to.

Mistake #3:
The “face only” approach

“The most neglected spots I see are the neck, chest, and backs of hands,” says Dr. Hale. “I can look at a woman’s chest and instantly tell how much sun damage she’s gotten based on the way her skin looks.” That damage raises your cancer risk—and it makes you look older too. In fact, up to 90 percent of visible signs commonly blamed on aging are caused by the sun, Dr. Hale says. Adds Dr. Marmur, “I totally get that no 20-year-old is worried about sun damage on these areas. But I have plenty of women just in their thirties who come in complaining about the brown spots all over the backs of their hands and their crinkly neck and chest, and it’s often because they didn’t use enough sunscreen years ago. Take the 10 extra seconds and be sure to protect those spots.” Don’t count on the SPF in your lotion or face cream to do the job, either. “It’s better than nothing,” Dr. Marmur says, “but if you’re outside for more than a few minutes, you need actual sunscreen. The thin layer of SPF from your moisturizer isn’t going to protect you.”

Mistake #4:
Putting too much faith in self-tanners

“I’ve had many patients who think these products somehow offer UV protection or that they give them a ‘base tan’ so they won’t burn,” says Dr. Hale. “But the color that self-tanners create on your skin is completely artificial.” Also, be perfectly honest with yourself about why you’re self-tanning. The whole idea, of course, is that if you get the bronzed-goddess effect from a bottle, you’ll be less likely to want a sun-induced tan. “But a lot of young women use these products so they don’t look pale when they go to the beach to tan,” says Dr. Hale. According to research at Emory University in Atlanta, 86 percent of women surveyed who use self-tanners reported they’d also baked in the sun, and 36 percent admitted they’d also used tanning beds (a leading cause of melanoma!) at least once in the past year. And a recent Australian study confirms that sunless tanning likely did not reduce the amount of UV exposure women get. Please: Keep your fake tan truly fake, and wear sunscreen over it.

Mistake #5: Tan obsession (yes, still)

Even in 2012, too many women think tans are hot. But “when I see a woman with bronzed skin, I look at it the way you might picture the inside of a smoker’s lungs,” says Dr. Marmur. “When UV light traumatizes the skin, brown pigment, or melanin, covers cells like a shield, trying to protect the fragile DNA inside from burning. This happens extremely quickly—within about 20 minutes of being outside without adequate protection. A tan is essentially your skin cells screaming, ‘Ouch!’” Even scarier, doing damage to your skin can actually be addictive. In a new study, researchers at the University of Texas Southwestern Medical Center in Dallas discovered that when frequent tanning-bed users were exposed to UV rays, the areas of their brains associated with reward lit up—similar to the way an addict’s brain lights up when exposed to drugs. Best way to beat the addiction: Just don’t start.

Mistake #6:
The “just this once” sun binge

Many women think that a trip to Aruba can’t be as damaging as spending day after day by the pool. You can develop skin cancer in both scenarios, of course. But periods in which you get intense amounts of sun all at once—a phenomenon dermatologists call “sunbursting”—are more likely to cause potentially deadly melanoma, because, very often, the skin hasn’t seen the sun for a while, so its defenses are down.

Compounding the problem: When you’re on vacation, you want to spend all day at the beach, right? “There’s this false sense of security that just because you’re wearing SPF 50, it’s OK to be out,” says Dr. Wang. “But that’s not the purpose of sunscreen—to allow you to stay in the sun longer—and it’s not meant to be your sole means of protection. You still need to sit in the shade, wear sunglasses and a hat, and reapply that sunscreen.” Dr. Hale agrees: “I see women all the time who come into my office after a week in Aruba and have a tan, yet they swear they wore enough sunscreen the whole time. I want to say, ‘Well, no, you didn’t, because you got a tan!’ They are out all day and aren’t great at reapplying.” By comparison, chronic sun exposure—like the kind you might get from spending a couple of hours a day outside all summer—is more linked to squamous cell carcinoma (still skin cancer but not as deadly as melanoma). “Farmers, for example, don’t tend to get melanoma,” explains Dr. Hale. “Their skin is a wrinkled mess, and they get other types of cancers.”

Your bottom line

You don’t want any type of cancer—or sun-provoked wrinkles, for that matter. So protect yourself, but don’t feel you need to deny all sunny pleasures to do it.

“Women see sun safety as a black-and-white issue,” says Dr. Marmur. “They feel like they either need to hide inside all summer to protect their skin, or they just say, ‘Eh, screw it.’ The message I’d like to get across is: Enjoy your life. Go to the beach with your friends, take a walk, but yes, use sun protection. There’s no question that being out on a warm, sunny day feels amazing. Just be a little bit smarter about it.”

Shaun Dreisbach is a contributing editor at Glamour. She has had no recurrence of skin cancer.